Basic Information
| Provider Information | |||||||||
| NPI: | 1801823182 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANESTHESIA ASSOCIATES, PLL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 77033 | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441947033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4403500832 | ||||||||
| FaxNumber: | 4403547420 | ||||||||
| Practice Location | |||||||||
| Address1: | 7757 AUBURN RD | ||||||||
| Address2: | SUITE 15 | ||||||||
| City: | PAINESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440779609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4403500832 | ||||||||
| FaxNumber: | 4403547420 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 07/12/2019 | ||||||||
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| AuthorizedOfficialLastName: | DONOHUE | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | F | ||||||||
| AuthorizedOfficialTitleorPosition: | SENIOR MANAGING PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 4403500832 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 2754149 | 05 | OH | MEDICAID |